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Waist-height ratio as a predictor of coronary heart disease among women.
Epidemiology. 2009 May; 20(3):361-6.E

Abstract

BACKGROUND

It is not yet established what specific measures of obesity might be most strongly associated with risk of coronary artery disease. We compared the waist-height ratio to waist-hip ratio, waist circumference, and body mass index as predictors of subsequent coronary heart disease (CHD) in a group of predominantly postmenopausal women.

METHODS

The data come from the prospective Nurses' Health Study cohort. We included 45,563 women in 1986 who were aged 40-65 years and were free of heart disease, stroke, and cancer. Waist circumference, hip circumference, height, weight, age, and other covariates were collected by questionnaire. Our primary end point was incident coronary heart disease reported up to June 2002. Areas under the receiver operating characteristic curves (AUCs) were estimated nonparametrically for each of the anthropometric measures. We estimated differences between the AUCs for weight-height ratio and the other measures, with corresponding 95% confidence intervals. We used Cox proportional hazard models to estimate the relationships with risk of CHD.

RESULTS

Waist-height ratio, waist-hip ratio, and waist circumference were similar in predicting subsequent risk of CHD. All 3 waist-derived measures were superior to body-mass index (BMI) in predicting CHD. The unadjusted AUCs were 0.62 (95% confidence interval = 0.60-0.64) for waist-height ratio, 0.63 (0.61-0.65) for waist-hip ratio, 0.62 (0.60-0.64) for waist-circumference, and 0.57 (0.55-0.59) for BMI.

CONCLUSION

Waist-height ratio is comparable with waist circumference and waist-hip ratio for prediction of coronary heart disease incidence among middle-aged and older women, but superior to BMI.

Authors+Show Affiliations

Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. john_page@post.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19289960

Citation

Page, John H., et al. "Waist-height Ratio as a Predictor of Coronary Heart Disease Among Women." Epidemiology (Cambridge, Mass.), vol. 20, no. 3, 2009, pp. 361-6.
Page JH, Rexrode KM, Hu F, et al. Waist-height ratio as a predictor of coronary heart disease among women. Epidemiology. 2009;20(3):361-6.
Page, J. H., Rexrode, K. M., Hu, F., Albert, C. M., Chae, C. U., & Manson, J. E. (2009). Waist-height ratio as a predictor of coronary heart disease among women. Epidemiology (Cambridge, Mass.), 20(3), 361-6. https://doi.org/10.1097/EDE.0b013e31819f38f1
Page JH, et al. Waist-height Ratio as a Predictor of Coronary Heart Disease Among Women. Epidemiology. 2009;20(3):361-6. PubMed PMID: 19289960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Waist-height ratio as a predictor of coronary heart disease among women. AU - Page,John H, AU - Rexrode,Kathryn M, AU - Hu,Frank, AU - Albert,Christine M, AU - Chae,Claudia U, AU - Manson,Joann E, PY - 2009/3/18/entrez PY - 2009/3/18/pubmed PY - 2009/8/4/medline SP - 361 EP - 6 JF - Epidemiology (Cambridge, Mass.) JO - Epidemiology VL - 20 IS - 3 N2 - BACKGROUND: It is not yet established what specific measures of obesity might be most strongly associated with risk of coronary artery disease. We compared the waist-height ratio to waist-hip ratio, waist circumference, and body mass index as predictors of subsequent coronary heart disease (CHD) in a group of predominantly postmenopausal women. METHODS: The data come from the prospective Nurses' Health Study cohort. We included 45,563 women in 1986 who were aged 40-65 years and were free of heart disease, stroke, and cancer. Waist circumference, hip circumference, height, weight, age, and other covariates were collected by questionnaire. Our primary end point was incident coronary heart disease reported up to June 2002. Areas under the receiver operating characteristic curves (AUCs) were estimated nonparametrically for each of the anthropometric measures. We estimated differences between the AUCs for weight-height ratio and the other measures, with corresponding 95% confidence intervals. We used Cox proportional hazard models to estimate the relationships with risk of CHD. RESULTS: Waist-height ratio, waist-hip ratio, and waist circumference were similar in predicting subsequent risk of CHD. All 3 waist-derived measures were superior to body-mass index (BMI) in predicting CHD. The unadjusted AUCs were 0.62 (95% confidence interval = 0.60-0.64) for waist-height ratio, 0.63 (0.61-0.65) for waist-hip ratio, 0.62 (0.60-0.64) for waist-circumference, and 0.57 (0.55-0.59) for BMI. CONCLUSION: Waist-height ratio is comparable with waist circumference and waist-hip ratio for prediction of coronary heart disease incidence among middle-aged and older women, but superior to BMI. SN - 1531-5487 UR - https://www.unboundmedicine.com/medline/citation/19289960/Waist_height_ratio_as_a_predictor_of_coronary_heart_disease_among_women_ L2 - http://dx.doi.org/10.1097/EDE.0b013e31819f38f1 DB - PRIME DP - Unbound Medicine ER -